AB1059 NETRIN-1 IN SPONDYLOARTHRITIS: A NOVEL MARKER TO PREDICT DISEASE ACTIVITY?
Authors: F. Baykal, S. Erten, S. C. Güven, A. Kor, F. Eren, S. Neşelioğlu, B. Polat, K. Gok, B. Armagan, I. Dogan, Y. Maraş, S. Başer, O. Erel
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Netrin-1 is a chemorepulsant and inhibits the migration of monocytes, neutrophils and lymphocytes by activation of its receptors. It has been revealed that netrin-1 can limit the inflammatory response, reduce tissue damage due to hypoxia and simultaneously suppress apoptosis. Due to this immune regulatory role, it has been hypothesized that netrin-1 can be used as a biomarker in rheumatic diseases. <h3>Objectives</h3> To compare plasma netrin-1 levels in axial spondyloarthritis (SpA) patients with the healthy subjects and to evaluate its relationship with disease activity and other clinical and laboratory parameters. <h3>Methods</h3> Patients with axial SpA between the ages of 18-65 who applied to Ankara City Hospital Rheumatology outpatient clinic between November 2021 and January 2022 were consecutively enrolled upon acceptance to participate. Pregnant patients, patients with systemic disease other than axial SpA and patients who were taking regular medication other than axial SpA treatment were excluded. A control group was formed from healthy volunteers with similar age and gender characteristics. In both groups, in addition to regular laboratory tests netrin-1 level was measured by an Enzyme Linked ImmunoSorbent Assay (ELISA) kit with an analytical unit of pg/mL (Elabscience, Texas, USA, Catalog No: E-EL-H2328; Lot No: GZWTKZ5SWK). <h3>Results</h3> A total of 60 axial SpA patients and 56 healthy controls were included in the study. There was no statistically significant difference between the groups in terms of age, gender andnetrin-1 levels between patients and controls (Table 1). Data regarding clinical characteristics, HLA-B27 positivity, acute phase reactants at the time of evaluation and disease activity scores of the axial SpA group was presented in Table 1. No significant differences were observed in netrin-1 levels in any comparison among all axial SpA patients, in ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (nr-ax SpA) patient subgroups, and in healthy controls (all axial SpA vs control p=0,361, AS vs nr-axSpA p=0,790, AS vs control p=0,360, nr-axSpA vs control p=0,700). Netrin-1 levels had a significant positive correlation with BASDAI (r=0,301 p=0,032), ASDAS CRP (r=0,320 p=0,022), VAS pain (r=0,340 p=0,015). <h3>Conclusion</h3> Our results demonstrated a positive correlation between netrin-1 levels and disease activity in axial SpA patients, implying that netrin-1 may come to the forefront as a novel biomarker to predict disease activity in axial SpA. <h3>References</h3> [1]Tang Z, Xu C, Zhang G, Chen H. [Protect role of Netrin-1 in inflammatory response]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2016 Aug;28(8):756-60. Chinese. doi: 10.3760/cma.j.issn.2095- 4352.2016.08.020. PMID: 27434573. [2]Ranganathan PV, Jayakumar C, Mohamed R, Dong Z, Ramesh G. Netrin-1 regulates the inflammatory response of neutrophils and macrophages, and suppresses ischemic acute kidney injury by inhibiting COX-2-mediated PGE2 production. Kidney İnternational 2013;83(6):1087-1098. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.